How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $831.76 | Professional | None | $776.25 | $776.25 | $831.76 |
CareFirst Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $676.08 | Professional | None | $616.60 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,778.28 Typical High $3,162.28 | Facility | None | $630.96 | $1,778.28 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $602.56 Typical High $794.33 | Professional | None | $588.84 | $602.56 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $891.25 | Professional | None | $588.84 | $645.65 | $891.25 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $1,258.93 | Professional | None | $457.09 | $588.84 | $1,258.93 |
Wellpoint Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $912.01 | Professional | None | $512.86 | $512.86 | $912.01 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $389.05 Typical High $416.87 | Professional | 52 · Reduced service | $389.05 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $165.96 | Professional | 53 · Discontinued | $154.88 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $616.60 | Professional | 54 · Surgery only | $588.84 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $123.03 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $83.18 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $575.44 |
Where Maryland sits
The same service costs 8.7 times more in Wyoming than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Maryland· 41st of 51
$676
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.